Differentiated Thyroid Cancer

Question 1

do differentiated features mean a good or bad prognosis?

Answer 1

good

Question 2

what chemical do most differentiated thyrid tumours take up?

Answer 2

iodine

Question 3

what chemical is secreted by differentiated thyroid cancers?

Answer 3

thyroglobulin

Question 4

what hormone drives differentiated thyroid cancer?

Answer 4

TSH

Question 5

what lifestyle factors are NOT associated with thyroid cancer?

Answer 5

diet

smoking

Question 6

clinical presentation of differentiated thyroid cancer?

Answer 6

palpable nodule

Question 7

how does papillary thyroid cancer spread?

Answer 7

via lymphatics

Question 8

where does papillary thyroid cancer typically metastasise?

Answer 8

lungs
bone
liver
brain

Question 9

what thyroid disease is associated with papillary thyroid cancer?

Answer 9

autoimmune thyroiditis

Question 10

second most common thyroid cancer?

Answer 10

follicular

Question 11

what cancer would you suspect if the patient had enlarged lymph nodes?

Answer 11

papillary

Question 12

what investigation could you do if you suspected vocal cord palsy?

Answer 12

pre-operative laryngoscopy

Question 13

1st line investigation for suspected thyroid cancer?

Answer 13

USS guided fine needle aspiration

Question 14

at what age ranges is a new thyroid nodule a red flag?

Answer 14

<20

>50

Question 15

is being male or female a red flag for thyroid cancer?

Answer 15

male

Question 16

at what diameter does a new thyroid nodule become a red flag?

Answer 16

> 4cm

Question 17

irradiation experience in what areas is a red flag?

Answer 17

head

neck

Question 18

is vocal cord palsy a red flag?

Answer 18

yes

Question 19

first line treatment for thyroid cancer.?

Answer 19

surgery

Question 20

how are patients divided into low and high risk categories for thyroid surgery?

Answer 20

AMES
age
metastases
extent of primary tumour
size of primary tumour

Question 21

at what age would a man become high risk for surgery?

Answer 21

40

Question 22

what age would a woman become high risk for surgery?

Answer 22

50

Question 23

20yr survival for high risk patients?

Answer 23

61%

Question 24

when would you do a thyroid lobectomy with isthmusectomy? is this for high or low risk patients

Answer 24

<1cm papillary carcinomas

low risk patients only

Question 25

what cancers comprise differentiated thyroid cancer?

Answer 25

papillary

follicular

Question 26

when would you do a total thyroidectomy?

Answer 26

high risk groups with distant metastases

Question 27

which electrolyte should be checked after the operation?

Answer 27

calcium

Question 28

what medication should you discharge the patient with?

Answer 28

T3 or T4

Question 29

when would you do whole body iodine scanning?

Answer 29

3-6 months after the patient has undergone either subtotal or total thyroidectomy

Question 30

what medication has to be stopped before going for whole body iodine scanning?

Answer 30

T3/4

Question 31

what is thyroid remnant ablation?

Answer 31

gets rid of any thyroid left after surgery

Question 32

where is a papillary cancer most likely to recur?

Answer 32

cervical lymph nodes